Algology means study of pain in medicine and is the specialty dedicated to the diagnosis and treatment of severe pain, particularly chronic pain that has persisted over time, pain whose source cannot be precisely identified or pain that is resistant to treatment. Acute pain is usually a sign of an injury or disease.
Chronic pain, which is the primary focus of algology, is a condition that significantly reduces a patient's quality of life and is considered a disease in its own right.
What is Algology (Pain Polyclinic)?
Algology is a branch of science that identifies the source of chronic pain that significantly reduces quality of life, investigates its causes and treats it using multidisciplinary methods. Also colloquially known as the ‘Pain Polyclinic’, algology is concerned with the management of chronic pain, especially cases lasting longer than three months and resistant to standard treatments.
Algology provides individualized treatment solutions for a wide range of conditions, from oncological pain to neuropathic pain, from herniated discs to resistant headaches. Its primary goal is to understand the mechanisms of pain, enable individuals to return to their daily activities and minimize the physical, psychological and social effects of pain.
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What Diseases Does Algology Treat?
The Department of Algology deals with chronic pain arising from the nervous system or resulting from tissue damage. The diseases managed by the Algology department include the following:
- Lumbar and cervical herniations: It manages patients who have not yet reached the surgical stage or who continue to experience pain after surgery.
- Cancer pains: It deals with severe pain caused by direct tumor pressure or by treatment processes (chemotherapy etc.).
- Neuropathic pains: It is characterized by burning, stabbing and numbness sensations associated with diabetes or nerve compression.
- Trigeminal neuralgia: They are severe pains that feel like electric shock in face region.
- Migraine and severe headaches: It deals with types of chronic headache that cannot be taken under control with medication.
- Fibromyalgia: It is a soft tissue rheumatic condition characterized by widespread muscle pain and tenderness throughout the body.
- Joint and skeletal system pains: It refers to chronic pain caused by osteoarthritis in the knee, hip and shoulder regions.
- Post-zoster pains (Postherpetic neuralgia): It is persistent pain that remains in the nerve endings after zoster rashes have healed.
- Phantom pain: It is phantom pain felt in a missing limb (arm, leg).
What Are The Diagnosis Methods Use In Algology Department?
In the Algology department, steps are taken to break the cycle of chronic pain that directly affects the patient’s quality of life. Advanced imaging techniques and interventional tests are used to determine whether the pain is central or peripheral and individualized treatment protocols are then developed.
Physical Examination and Anamnesis Process in Algology
The first and most important stage of the diagnostic process is a detailed medical history (anamnesis) and the performing of specific neurological examinations. The doctor assesses the onset of pain, triggering factors and the character of the pain (like burning, stabbing or electric shock). The basic evaluation methods applied during the physical examination are as follows:
- Dermatoma analysis: Assessment of sensory areas of nerve roots in the body are provided.
- Muscle strength tests: It is performed to determine the motor losses related to nerve compression.
- Reflex examination: Deep tendon reflexes are measured.
- Provocative tests: It involves observing whether pain is triggered by specific movements.
Imaging Methods and Radiological Tests
Algology specialists use high-resolution radiological imaging devices to visualize the anatomical source of pain. These methods clearly reveal tissue damage, herniations or joint degeneration. The main imaging technologies used in modern algology are as follows:
Magnetic Resonance Imaging (MRI): It enables detailed examination of soft tissues, nerve roots and disc structures.
Computed Tomography (CT): It is used to detect abnormalities and calcifications in bone structure.
Ultrasonography (USG): It allows real-time observation of nerve compression and increased intra-articular fluid.
Direct X-Ray: It is the first step in evaluating spinal alignment and mechanical problems.
Diagnostic Blocks (Interventional Diagnosis Methods)
One of the key features that distinguishes algology from other branches is the use of “diagnostic blocks" for diagnostic purposes. If a local anesthetic injection into a nerve temporarily relieves pain, it confirms that the pain originates from that nerve. The interventional methods applied for diagnosis are as follows:
- Selective Nerve Root Blocks: It is the confirmation of the pain source by administering medication to a specific nerve root.
- Facet Joint Blocks: It is performed to assess the contribution of spinal joint osteoarthritis to pain.
- Sympathetic Blocks: It is performed to differentiate pain originating from the sympathetic nervous system.
- Medial Branch Block: It is the testing of nerve conduction in low back and neck pain.
Electrophysical Tests
Tests that measure nerve conduction velocity and the electrical activity of muscles are essential, particularly in the diagnosis of neuropathic pain. These tests provide quantitative data on the degree and location of nerve damage. Electrophysical methods used in algology clinics are as follows:
- EMG (Electromyography): It is the assessment of the functional status of muscles and nerves.
- SEP and MEP Tests: It is the measurement of sensory and motor evoked potentials.
- Quantitative Sensory Testing (QST): It is the analysis of heat, cold and touch thresholds.
Laboratory Tests and Functional Analysis
Blood tests are used to identify underlying inflammatory processes or metabolic deficiencies contributing to pain. In some cases, vitamin deficiencies or rheumatic diseases may be the primary cause of chronic pain. Laboratory tests that will be requested in diagnosis process are as follows:
- Inflammation Markers: CRP and Sedimentation values are checked.
- Rheumatic Panels: Autoimmune tests like RF, Anti-CCP are performed.
- Vitamin and Mineral Levels: Especially vitamin B12, D vitamin and magnesium measurements are performed.
- Hormone Profile: Endocrine disorders that may affect pain threshold are evaluated
When To See An Algology Specialist?
If the pain has progressed beyond the acute phase and conventional painkillers or physical therapy are ineffective, consultation with an algology specialist is recommended. The pain becoming chronic can cause permanent changes in nervous system so early intervention is of great importance.
In cases of long-term pain that disrupts sleep, causes movement limitations or leads to depressive mood, pain polyclinics adopt a multidisciplinary approach. In this process, algologists work in coordination with orthopedics, neurology, physiotherapy and psychiatry departments to manage a comprehensive care process.
